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目的:探究老年脑卒中抑郁患者血清中微RNA-26b(miR-26b)、微RNA-1(miR-1)表达情况及其与患者预后的关系。方法:选取2017年3月至2018年2月在湖北省中医院进行治疗的148例老年脑卒中患者，根据入院后HAMD评分分为单纯脑卒中组(60例，HAMD评分<7分)和脑卒中抑郁组(88例，HAMD评分≥7分)。采用实时荧光定量PCR(qRT-PCR)法对所有受试者血清中miR-26b、miR-1水平进行检测，分析miR-26b、miR-1表达与患者临床参数的关系；分析miR-26b、miR-1表达与患者预后的关系；采用logistic回归分析影响脑卒中患者抑郁预后影响因素。结果:脑卒中抑郁组患者血清中miR-26b表达显著低于单纯脑卒中组，miR-1表达显著高于单纯脑卒中组(n P<0.05)。miR-26b低表达者及miR-1高表达者HAMD评分显著高于miR-26b高表达者、miR-1低表达者(n P<0.05)。Pearson分析显示，miR-26b与HAMD评分呈负相关(n r＝-0.364，n P<0.01)，miR-1与HAMD评分呈正相关(n r＝0.392，n P<0.01)。不同预后的脑卒中抑郁患者中，痊愈组HAMD评分、miR-1表达显著低于未痊愈组，miR-26b表达显著高于未痊愈组(n P<0.05)。Logistic多因素回归分析显示HAMD评分、miR-1是影响脑卒中抑郁患者发生不良预后的危险因素，miR-26b是影响脑卒中抑郁患者发生不良预后的保护因素。n 结论:老年脑卒中抑郁患者血清miR-1水平升高，miR-26b水平降低，两者与患者预后有关，均是脑卒中抑郁患者发生不良预后的影响因素。“,”Objective:To investigate the expressions of microRNA-26b (miR-26b) and microRNA-1 (miR-1) in serum of elderly patients with stroke depression and their relationships with prognosis.Methods:148 elderly stroke patients treated in Hubei Provincial Hospital of Traditional Chinese Medicine from March 2017 to February 2018 were divided into simple stroke group [60 cases, Hamilton Depression Scale (HAMD) score <7 points] and stroke depression group (88 cases, HAMD score ≥7 points). Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the levels of microRNA-26b and microRNA-1 in the serum of all subjects; the relationships between the expressions of microRNA-26b and microRNA-1 and clinical parameters were analyzed, the relationship between the expressions of microRNA-26b and microRNA-1 and the prognosis of patients were analyzed; Logistic regression was used to analyze the prognostic factors of depression in stroke patients.Results:The expression of microRNA-26b in serum of patients in stroke depression group was significantly lower than that of patients in simple stroke group, and the expression of miR-1 was significantly higher than that of patients in simple stroke group (n P<0.05). The HAMD scores of patients with low expression of microRNA-26b and the high expression of miR-1 were significantly higher than those of patients with high expression of microRNA-26b and the low expression of miR-1 (n P<0.05). Pearson analysis showed that there was a significant negative correlation between microRNA-26b and HAMD score (n r=-0.364, n P<0.01), and a significant positive correlation between miR-1 and HAMD score (n r=0.392, n P<0.01). In the stroke depression patients with different prognosis, the HAMD score and the expression of miR-1 in the cured group were significantly lower than those in the non-cured group, and the expression of microRNA-26b was significantly higher than that in the non-cured group (n P<0.05). Logistic regression analysis showed that HAMD and miR-1 were the risk factors of poor prognosis in patients with stroke depression, and miR-26b was the protective factor of poor prognosis in patients with stroke depression.n Conclusions:The levels of serum miR-1 and mir-26b were increased and decreased in elderly patients with stroke depression. Both of them were related to the prognosis of patients and were the influencing factors of adverse prognosis in patients with stroke depression.